Trail, Kynan Charles

Trail, Kynan Charles is an individual health care provider with primary practice located at 2525 Fox Run Pkwy Suite 204, Yankton SD 57078-5370. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Trail, Kynan Charles can be contacted via phone (605) 668-9670.

Contact Information

Primary practice address
2525 Fox Run Pkwy Suite 204 Yankton SD 57078-5370
Phone: (605) 668-9670
Fax: (605) 668-0371
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4733 South Dakota

Profile Details

NPI number 1962452458
LBN Legal business name Trail, Kynan Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jul 19th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962452458 NPPES
Nebraska MEDICAID 46045455602
Nebraska MEDICAID 7301750

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